Quick ABC Data Form with Duration (Customizable)

(Hi-lite or circle events from each column and indicate time of day)

Date:______Student:______Observer:______

Time / Location / Activity at
Onset / Trigger/Antecedent / Behaviour
(modify/customize form to address 3-4 main behaviours of concerns) / Consequence
Events immediately after behaviour / Duration / Intensity / Comment
Transition(Hallway)
Classroom
Learning Support
Outside
Library
Gym
Washroom
Counsellor’s Room
LS Room
Other: / Subject:______
Independent work
Group work
Carpet time
Lunch
Recess
Other: / Interruption
Task demand
Transition to non-preferred
Transition from highly preferred
Adult demand
Request denied
Change in Routine
Other: / Refusal to follow adult direction
Refusal to complete task
Negative comments about self
Negative comments toward peers
Yell/Scream
Safety Concern:
Other: / Ignore
Verbal Redirect
Adult Attention
Escape area
Avoid task
Other: / 0-1min.
1-5min.
5-10min.
10-15min.
15+ min. / Low – 1
Medium – 2
High - 3
Transition(Hallway)
Classroom
Learning Support
Outside
Library
Gym
Washroom
Counsellor’s Room
LS Room
Other: / Subject:______
Independent work
Group work
Carpet time
Lunch
Recess
Other: / Interruption
Task demand
Transition to non-preferred
Transition from highly preferred
Adult demand
Request denied
Change in Routine
Other: / Refusal to follow adult direction
Refusal to complete task
Negative comments about self
Negative comments toward peers
Yell/Scream
Safety Concern:
Other: / Ignore
Verbal Redirect
Adult Attention
Escape area
Avoid task
Other: / 0-1min.
1-5min.
5-10min.
10-15min.
15+ min. / Low – 1
Medium – 2
High - 3
Transition(Hallway)
Classroom
Learning Support
Outside
Library
Gym
Washroom
Counsellor’s Room
LS Room
Other: / Subject:______
Independent work
Group work
Carpet time
Lunch
Recess
Other: / Interruption
Task demand
Transition to non-preferred
Transition from highly preferred
Adult demand
Request denied
Change in Routine
Other: / Refusal to follow adult direction
Refusal to complete task
Negative comments about self
Negative comments toward peers
Yell/Scream
Safety Concern:
Other: / Ignore
Verbal Redirect
Adult Attention
Escape area
Avoid task
Other: / 0-1min.
1-5min.
5-10min.
10-15min.
15+ min. / Low – 1
Medium – 2
High - 3

Quick ABC Data Form with Duration (Customizable)

(Hi-lite or circle events from each column and indicate time of day)

Date:______Student:______Observer:______

Time / Location / Activity at
Onset / Trigger/Antecedent / Behaviour
(modify/customize form to address 3-4 main behaviours of concerns) / Consequence
Events immediately after behaviour / Duration / Intensity / Comment
Transition(Hallway)
Classroom
Learning Support
Outside
Library
Gym
Washroom
Counsellor’s Room
LS Room
Other: / Subject:______
Independent work
Group work
Carpet time
Lunch
Recess
Other: / Interruption
Task demand
Transition to non-preferred
Transition from highly preferred
Adult demand
Request denied
Change in Routine
Other: / Refusal to follow adult direction
Refusal to complete task
Negative comments about self
Negative comments toward peers
Yell/Scream
Safety Concern:
Other: / Ignore
Verbal Redirect
Adult Attention
Escape area
Avoid task
Other: / 0-1min.
1-5min.
5-10min.
10-15min.
15+ min. / Low – 1
Medium – 2
High - 3
Transition(Hallway)
Classroom
Learning Support
Outside
Library
Gym
Washroom
Counsellor’s Room
LS Room
Other: / Subject:______
Independent work
Group work
Carpet time
Lunch
Recess
Other: / Interruption
Task demand
Transition to non-preferred
Transition from highly preferred
Adult demand
Request denied
Change in Routine
Other: / Refusal to follow adult direction
Refusal to complete task
Negative comments about self
Negative comments toward peers
Yell/Scream
Safety Concern:
Other: / Ignore
Verbal Redirect
Adult Attention
Escape area
Avoid task
Other: / 0-1min.
1-5min.
5-10min.
10-15min.
15+ min. / Low – 1
Medium – 2
High - 3
Transition(Hallway)
Classroom
Learning Support
Outside
Library
Gym
Washroom
Counsellor’s Room
LS Room
Other: / Subject:______
Independent work
Group work
Carpet time
Lunch
Recess
Other: / Interruption
Task demand
Transition to non-preferred
Transition from highly preferred
Adult demand
Request denied
Change in Routine
Other: / Refusal to follow adult direction
Refusal to complete task
Negative comments about self
Negative comments toward peers
Yell/Scream
Safety Concern:
Other: / Ignore
Verbal Redirect
Adult Attention
Escape area
Avoid task
Other: / 0-1min.
1-5min.
5-10min.
10-15min.
15+ min. / Low – 1
Medium – 2
High - 3